Should I go for drugs or diet?

If your doctor believes that you have Ulcerative Colitis (UC), you have little choice. UC does not respond to dietary changes, and the inflammation will continue unless you take medication to suppress it.  Sometimes people with UC have food intolerances as well, which may cause bouts of diarrhoea, but even if you avoid the foods which you have discovered to have this effect, the inflammation in the bowel wall will persist.

Crohn’s Disease (CD) on the other hand, is quite different.  There are many scientific papers reporting on the way that this disease may be put into remission by an appropriate diet. On the other hand, it will also often respond satisfactorily to the same drugs as are used in UC. Patients with  CD therefore have a choice.

There are a number of factors to consider here. Tablets are easy to take, and no-one need know what they are if you don’t want them to. They usually work quickly, and if they don’t your doctor can suggest alternatives which may prove more suitable. On the other hand there are a number of questions to think about first:

1. Have any drugs upset me in the past?
2. Do I prefer to take tablets which may cause side-effects or allergic reactions?
3. Do I suffer any health problems (e.g. chronic infections elsewhere in the body, or osteoporosis) which might be made worse by drugs?
4. Has medication been effective in the past – or have results been disappointing?
5. Some drugs (e.g. methotrexate) are dangerous in pregnancy and are therefore sometimes unsuitable for young women.

Diet is wonderful when it is sorted out. There is complete control of the disease, and if you wish to make certain that you are in good health, such as before an exam or a holiday, you can ensure that nothing goes wrong by following the diet conscientiously. For young women, it is important to realise that diet allows a normal pregnancy. What is more, there is no risk of drug side-effects, and after a few months the diet becomes such second nature that many forget that they are on a diet at all! However, it also presents difficulties and some factors to consider may be:

1. Am I prepared to keep strictly to a liquid diet for two or three weeks to get my CD into remission?
2. Am I prepared to stick faithfully to the diet whilst I re-introduce foods one by one to see which ones upset me – and put up with symptoms for a few days when they do?
3. If I find that I am upset by an everyday food such as bread or cheese, will I have the determination to avoid them on social occasions or will it make me embarrassed and upset?